Chunk #12 — 5. Inflammasome is a key mediator of stress, depression and comorbid illnesses — 5.2. Inflammatory cytokines and dysfunction of the HPA axis
Decreased glucocorticoid receptor (GR) expression and function and loss of negative feedback could also contribute to IL-1β activation of the HPA axis (Hill et al., 1988; Pace and Miller, 2009; Pariante et al., 1999; Verheggen et al., 1996). A role for GR dysfunction is also consistent with the evidence of glucocorticoid resistance (i.e., decreased dexamethasone suppression) that is correlated with increased IL-1 in depressed patients (Maes et al., 1993). This resistance, which could be caused by inflammatory cytokine activation of the HPA axis, is puzzling because glucocorticoids inhibit IL-1β production and release (Goshen and Yirmiya, 2009; Maes et al., 1993; Snyder and Unanue, 1982).
